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<font face="Arial" style="font-size: 11pt; font-style: italic"><b>Biologic 
therapy for psoriasis: telephone triage.</b></font></p>
<p style="margin-left: 10"><b><font face="Arial" size="2">Pearce DJ, Boles A, 
Greist HM, Feldman SR.</font></b></p>
<p style="margin-left: 10"><font face="Verdana" size="2">Dermatology Resident, 
Wake Forest University School of Medicine, Winston-Salem, NC, USA.<br>
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The past 15 years have been a time of remarkable achievement in the treatment of 
psoriasis. New topical medications with efficacy and safety have been 
introduced. At the same time, there has been resurgence in the use of 
traditional agents such as methotrexate and cyclosporine. An enlightened 
understanding of psoriasis as an immune-mediated disease has led to the 
development of unique injectable medications called biologics. All of these 
developments have occurred in part as we have gained a better understanding of 
the powerful impact that psoriasis has on patients. The biologics represent a 
new and exciting class of medications for treating psoriasis. Their novelty is 
reflected by both excitement and uncertainty. Efficacy rates of the biologics in 
treating psoriasis are unparalleled and safety data over the short term is 
promising. However, long-term safety data does not exist. Furthermore, as with 
any new class of medication, specifically an injectable preparation costing 
approximately $18,000 to $30,000 annually, concern on the part of patients is 
expected. Despite any uncertainty, the biologics are drastically altering the 
arena of psoriasis care. Clinicians have an entirely new class of medications to 
recommend to patients who have either failed or are not eligible for traditional 
agents. At the same time, due to the expense of these agents, the relationship 
between the patient, clinician, and insurer is changing. Certainly the 
introduction of biologics has created a need for educating clinic staff 
regarding these therapies. There are barriers to the effective and safe use of 
the biologics; often, these barriers lie at the level of the patient and depend 
on his comfort level and understanding of the treatment. This being said, it is 
the charge of the dermatology community, especially those on the front lines 
such as nurses, to lead efforts in patient education to ensure the best care for 
those suffering from psoriasis.</font></p>
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